title: Management of radiation-induced rectal bleeding.
abstract: Pelvic radiation disease is one of the major complication after radiotherapy for pelvic cancers. The most commonly reported symptom is rectal bleeding which affects patients' quality of life. Therapeutic strategies for rectal bleeding are generally ignored and include medical, endoscopic, and hyperbaric oxygen treatments. Most cases of radiation-induced bleeding are mild and self-limiting, and treatment is normally not indicated. In cases of clinically significant bleeding (i.e. anaemia), medical therapies, including stool softeners, sucralfate enemas, and metronidazole, should be considered as first-line treatment options. In cases of failure, endoscopic therapy, mainly represented by argon plasma coagulation and hyperbaric oxygen treatments, are valid and complementary second-line treatment strategies. Although current treatment options are not always supported by high-quality studies, patients should be reassured that treatment options exist and success is achieved in most cases if the patient is referred to a dedicated centre.
authors.affiliation: Unit of Gastroenterology, Department of Medical and Surgical Sciences, S.Orsola-Malpighi University Hospital, Via Massarenti 9, 40138, Bologna, Italy.
authors.forename: Liboria
authors.initials: L
authors.lastname: Laterza
authors.forename: Paolo
authors.initials: P
authors.lastname: Cecinato
authors.forename: Alessandra
authors.initials: A
authors.lastname: Guido
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mussetto
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fuccio
mesh_terms: D003131:Combined Modality Therapy; D016099:Endoscopy, Gastrointestinal; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006489:Hemostatic Techniques; D006801:Humans; D006931:Hyperbaric Oxygenation; D010386:Pelvic Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology / Q000628:therapy*; D012007:Rectum
chemical_list: D005765:Gastrointestinal Agents